§ 12-15-13-1 — Payment, denial, or suspension of claims submitted by nursing facilities; time; notice of suspension or denial

Indiana § 12-15-13-1

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 13: Provider Payment; General

Text

(a) This section applies only to claims
submitted for payment by nursing facilities.
(b) The office shall pay, deny, or suspend each claim submitted by
a provider for payment under the Medicaid program not more than:
(1) twenty-one (21) days after the date a claim that is filed
electronically; or
(2) thirty (30) days after the date a claim that is filed on paper;
is received by the office or, if IC 12-15-30 applies, by the contractor
under IC 12-15-30.
(c) The office shall pay each clean claim.
(d) The office may deny or suspend a claim that is not a clean claim.
If the office denies a provider's claim for payment, the office shall
notify the provider of each reason the claim was denied.
(e) If the office suspends a provider's claim for payment under the
Medicaid program, the office shall notify the provider of each reason
the claim was suspended.
[Pre-1992 Revision Citation: 12-1-7-16.5.]

Legislative History

As added by P.L.2-1992, SEC.9. Amended by P.L.10-1994, SEC.4; P.L.107-1996, SEC.5; P.L.257-1996, SEC.5.